缺血性中风患者的癌症和左心房扩大：癌症相关中风的心房心病。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2024-09-28 DOI:10.1016/j.jstrokecerebrovasdis.2024.108045

Morin Beyeler MD , Anokhi Pawar BS , Eric Buffle MD , Cenai Zhang MS , Vanessa Liao BS , Ava L. Liberman MD , Thomas Pabst MD , Martin D. Berger MD , Simon Jung MD , Hooman Kamel MD , Babak B. Navi MD MS

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引用次数: 0

摘要

背景：癌症与心房颤动风险增加有关。癌症是否也与心房性心脏病（另一种与缺血性中风风险增加有关的心房病变）相关尚不确定：我们对 2011 年至 2016 年在美国纽约一家四级医疗中心住院的急性缺血性中风连续患者进行了一项回顾性横断面研究。研究对象为活动性癌症。研究结果为心房性心脏病，定义为超声心动图检查左心房容积指数≥35 mL/m2。我们使用多变量逻辑回归来评估癌症（活动性或历史性）与心房性心脏病之间的关系，并对基线特征进行了调整。我们对来源不明的栓塞性中风（ESUS）患者进行了亚组分析：最终队列包括 1104 名急性缺血性卒中患者，其中 10% 患有活动性癌症，47% 患有心房性心脏病。与无心房性心脏病的患者相比，有心房性心脏病的患者年龄更大（中位年龄为 77 岁对 68 岁），更常患有高血压、冠心病和心房颤动。9.6%的心房性心脏病患者（人数=50/520）和10.4%的非心房性心脏病患者（人数=61/584）患有活动性癌症。在整个缺血性卒中队列中，活动性癌症与心房性心脏病之间没有关联（调整后的几率比 [OR]，0.91；95% 置信区间 [CI]，0.60-1.37），在 ESUS 患者中也没有关联（aOR，0.64；95% 置信区间 [CI]，0.30-1.36）。当癌症暴露范围扩大到包括任何癌症病史时（n=236，21.4%），仍与心房性心脏病无显著关联（aOR，0.93；95% CI，0.68-1.25）：结论：根据左心房容积定义心房性心脏病时，我们没有发现缺血性卒中患者（包括 ESUS 患者）中癌症与心房性心脏病之间存在关联。未来的研究需要评估其他心房心病生物标志物和环境，以进一步研究癌症与心房心病之间的潜在联系。

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Cancer and left atrial enlargement in patients with ischemic stroke

Background

Cancer is associated with an increased risk of atrial fibrillation. Whether cancer is also associated with atrial cardiopathy, another atrial pathology associated with heightened ischemic stroke risk, is uncertain.

Methods

We conducted a retrospective cross-sectional study among consecutive patients hospitalized with acute ischemic stroke at a quaternary care center in New York, United States from 2011 through 2016. The study exposure was active cancer. The study outcome was atrial cardiopathy, defined as a left atrial volume index ≥35 mL/m² on echocardiography. We used multivariable logistic regression, adjusting for baseline characteristics, to evaluate the relationship between cancer (active or historical) and atrial cardiopathy. We performed a subgroup analysis among patients with embolic stroke of undetermined source (ESUS).

Results

The final cohort included 1104 patients with acute ischemic stroke, of whom 10 % had active cancer and 47 % had atrial cardiopathy. Patients with atrial cardiopathy, compared to those without, were older (median age, 77 versus 68 years), and more frequently had hypertension, coronary disease, and atrial fibrillation. Active cancer was present in 9.6 % of patients with atrial cardiopathy (n = 50/520) and 10.4 % of patients without (n = 61/584). There was no association between active cancer and atrial cardiopathy among the overall ischemic stroke cohort (adjusted odds ratio [OR], 0.91; 95 % confidence interval [CI], 0.60-1.37) nor in patients with ESUS (aOR, 0.64; 95 % CI, 0.30-1.36). When the cancer exposure was broadened to include any history of cancer (n = 236, 21.4 %), there still was no significant association with atrial cardiopathy (aOR, 0.93; 95 % CI, 0.68-1.25).

Conclusions

When defining atrial cardiopathy by left atrial volume, we did not find an association between cancer and atrial cardiopathy in patients with ischemic stroke, including among those with ESUS. Future studies, evaluating other atrial cardiopathy biomarkers and settings, are needed to further investigate any potential link between cancer and atrial cardiopathy.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.